An Overview of Child Welfare Tom C. Rawlings Director, Office of the Child Advocate Women’s Legislative Caucus Retreat Perry, GA October 16, 2007 Child Protection Answer for yourself: Is protecting our children society’s most important responsibility? The progress of a state may be measured by the extent it safeguards the rights of its children -- Grace Abbott, 1938 The test of the morality of a society is what it does for its children -- Dietrich Bonhoeffer, 1940’s There is no more important test of a society than how it treats its children -- Ronald Reagan, 1985 Brief history of child welfare Pre-1900: abandoned children (―foundlings‖) warehoused in ―almshouses‖ and orphanages 1840-1860: Huge influx of immigrants over-populates New York City, disrupted family structures, tenements, disease 1853: Charles Lorring Brace starts the ―Children’s Aid Society‖ of New York 1854-1930’s: ―Orphan Trains‖ ferried 150,000+ west The Old Ursuline Convent at 112 Chartres Street in the French Quarter, built in 1745, is believed to be the oldest building in the Mississippi Valley. In 1727 twelve women — Ursuline Nuns from France — established the first school for girls, ran the first free school and the first orphanage and held the first classes for African slave and Native American girls in what is now the United States. Brief history of child welfare American West promised pure air, food, work ethic Groups of 10-40 children, chosen by families at stops Mixed results, OrphanTrainRiders.com 1994 PBS documentary interviewed orphans Brief history of child welfare 1874: Mary Ellen Wilson, 9, abandoned in New York City, enslaved, beaten daily by her ―foster mother‖ No laws to protect children, no rights, viewed as property Etta Wheeler got the American Society for the Prevention of Cruelty to Animals to go to court Brooklyn court took protective custody, first ward of the court The beginning of the child- welfare system as we know it today Brief history of child welfare ―I saw a child brought in … at the sight of which men wept aloud, and I heard the story of little Mary Ellen told … that stirred the soul of a city and roused the conscience of a world that had forgotten, and as I looked, I knew I was where the first chapter of children's rights was being written‖ -- Jacob Riis, reporter, photo-journalist 1875: Society for the Prevention of Cruelty to Children chartered by Henry Bergh (also ASPCA founder) 1922: 300+ SPCC chapters Mary Ellen was raised by her rescuer’s sister, married at 24, 2 children who were teachers, died at 92 in 1956. Brief history of child welfare 1899: First Juvenile Court in Cook County, IL; rapid expansion, 46 states with juvenile courts by 1915 1912: Federal government forms the Children’s Bureau, begin shift from non-governmental SPCC’s 1935: Social Security Act, Aid to Dependent Children (later AFDC); CB works with state public welfare agencies; shift from institutions to foster care 1929-1962: Shift from publicity-hungry SPCC’s to publicity-shy government; confidentiality officially hides child welfare from the public; little research or professional social-work The Traditional Concept: Doctrine of ―Parens Patriae,‖ in which Court is ―In Loco Parentis‖ for child whose parents cannot control. Court as Big Daddy Brief history of child welfare 1962: C.H. Kempe publishes ―The battered-child syndrome‖ in the Journal of the American Medical Association 1960’s and 1970’s: Explosion of interest in child abuse and neglect, medical & social-work research 1969: Protecting the Child Victim of Sex Crimes Committed by Adults, Vincent de Francis, American Humane Society; research, women’s movements, rape reform reveal prevalence of child sexual abuse Where was the judicial branch during these changes? Sporadic Developing across country…..not standard Developed under a contract system—saw children still as property Also, concepts of ―child protection‖ were evolving…parent’s rights v. children’s rights…when should the state ―rescue‖…children need permanency in a home with a family…moving away from institutional care. In Re Gault - 1967 Concept of judicial review was emerging Case of Gerald Frances Gault pushed us down this path Recognized the liberty interest in a parent being able to raise one’s own child Concept of due process was applied to children Aftermath of In Re Gault But we didn’t keep teach clinicians the value of the law in this field, the role of due process and fundamental rights, how to investigate a case, or how to use evidence in a court of law We didn’t teach judges or lawyers about child development, children’s needs, or psychological issues about separating children from their families. Brief history of child welfare 1974: Child Abuse Prevention and Treatment Act, foundation of today’s federal regulations 1980: Adoption Assistance and Child Welfare Act tied federal dollars to judicial oversight 1993 Family Preservation Act (includes Safe and Stable Families funding and Court Improvement Projects). Brief history of child welfare 1997 Adoption & Safe Families Act (ASFA) Focus of law is on health and safety of the child Goal = end ―foster care drift‖ and move children into permanent homes more quickly Limits number of months child can be in foster care before TPR is filed Provides financial incentives to states to increase number of adoptions What we’re talking about Most child abuse comes in the form of neglect. Neglect is sinister; the damage is below the surface. Other abuse is more obvious, but the public is shielded from it -- that may be part of the problem. The next slide contains gruesome images of infant abuse victims. I’ll show them for a second, then move on. Avert your eyes ... What we’re talking about The Hazards of Neglect Early, frequent, and intense stress tunes the brain to set stress regulation mechanisms at high levels. This often results in a child operating in a persisting fear state. Under Stress, the Brain loses ability to take in subtle clues reverts to “tried & true” behaviors becomes more automatic & over reactive is less able to use “higher order” thinking skills loses some memory capacity Many Bad Adult Outcomes are associated with Child Abuse and Neglect (Putnam, 2002) Child Maltreatment is the Greatest Risk Factor for Major Public Health Problems Major Psychiatric Illnesses Health Risk Behavior (organic diseases later in life ) Alcohol and Substance Abuse in Women Crime and Violence in Women HIV High Risk Behaviors in Adolescents Childhood Trauma and Adult Outcome almost all criminal justice population (US) almost 50% arrested for nontraffic-related offenses by the age of 32 75% of perpetrators of child sexual abuse report to have been sexually abused (Teplin, 2002; Widom, 1996) Why Does Childhood Maltreatment Exert Such Powerful Effects? It occurs during sensitive developmental periods (e.g., Synaptogenesis, Experience-dependent Maturation of Neuronal Systems) It impacts on fundamental developmental processes (e.g., Attachment, Emotional Regulation, Impulse Control, Integration of Self, Socialization) F. W. Putnam, Mayerson Center for Safe & Healthy Children, Cincinnati Children’s Hospital Stevie L. Both parents mentally ill Arm broken at age 2, removed by DFCS Went to live with relatives In and out of Central State Inconsistent MH care Kicked out of CSB day treatment program Only seen by doc for meds Meds terribly inconsistent Originally refused by MATCH because of alleged MR diagnosis Referred to Juvenile Court for incidents at psychoed center What we’re talking about CPS agencies took 2.6 million reports involving 4.5 million Child Deaths Attributed to children in 2002 in the US. Abuse There are 73 million kids in 1600 the US, 4.1 million had an 1400 1373 1390 asthma attack in 2002. 1306 1200 1098 1089 979 900,000 children are ultimately 1000 935 found to be victims each year 800 700,000 receive services 600 265,000 children are removed 400 from their homes each year Death rate up 60% over 6 200 years 0 6 7 8 9 0 1 2 9 9 9 9 0 0 0 19 19 19 19 20 20 20 Source: DHHS ACF Children’s Bureau Child Maltreatment 2002 What we’re talking about Georgia takes maltreatment reports on about 127,000 children, finding about 41,000 victims each year. Maltreatment Types: US GA Neglect: 59% 78% Physical: 19% 16% Sexual: 10% 5% Neglect is every bit as damaging, just more degrees of it than other types of abuse About 60 fatalities per year What we’re doing about it Executive Judicial Non-Profit Governor’s Office Council of Foster Parents Dept. of Human Resources (DHR) Juvenile Court Treatment Providers Division of Family Judges Residential (e.g. and Children Council of Superior Group Homes) Services (DFCS) Court Judges Non-Residential Mental Health Public Health Administrative Office Assessment Office of the Child of the Courts Abuse Prevention Advocate (OCA) Court Appointed Family Preservation Dept. of Juvenile Special Advocates Justice (DJJ) Advocacy Attorney General (CASA) Child Advocacy Law Enforcement Guardians ad Litem Centers (GAL) What we’re doing about it Child Protective Services (CPS) Abuse Report Court (127,000) Screening Foster Care (70,000) Assessment Investigation Foster Home Assessments Services (24,000) (13,000) Removal CPS Reunify Other (4,500) Ongoing (3,600) Permanency (1,100) How are we doing at this? The number of children we remove from their families has nearly doubled in 5 years Georgia 2003: 4.2 per 10K Fulton 2003: 5.1 per 10K Illinois 1994: 4.5 per 10K Illinois 1998: 2.0 per 10K The number of children in foster care has increased 51% in 5 years, from 9,600 to 14,500 The DFCS budget has increased about 20%, from $860M to $1B How are we doing at this? We’re removing and returning Georgia: Children Re-Abused children to their families more within 6 Months quickly (78% within 12 months) 10% 9% We’re adopting children at 8.4% 8% about the same speed we did 7% 5 years ago (18% adopted 5.6% 6% within 24 months, 37 months 4.9% median) 5% 4.2% 4.2% 4.0% 4% 3.6% The 6-month re-abuse rate 3% has doubled in 5 years 2% The bright side: 5 years ago 1% we wouldn’t have known any 0% of this! 7 8 9 0 1 2 3 9 9 9 0 0 0 0 19 19 19 20 20 20 20 Major Challenges Most of our knowledge, laws, and responses to child abuse came within the last 50 years. They are still embryonic. Still, the body of state and federal child welfare law is tremendous, complex, and often confusing: layer after layer of statutes and regulations The Layers of Federal Law The Adoption and Safe Families Act of 1997 (a) IN GENERAL- Section 471(a)(15) of the Social Security Act (42 U.S.C. 671(a)(15)) is amended to read as follows: `(15) provides that-- `(A) in determining reasonable efforts to be made with respect to a child, as described in this paragraph, and in making such reasonable efforts, the child's health and safety shall be the paramount concern; `(B) except as provided in subparagraph (D), reasonable efforts shall be made to preserve and reunify families-- `(i) prior to the placement of a child in foster care, to prevent or eliminate the need for removing the child from the child's home; and `(ii) to make it possible for a child to safely return to the child's home; `(C) if continuation of reasonable efforts of the type described in subparagraph (B) is determined to be inconsistent with the permanency plan for the child, reasonable efforts shall be made to place the child in a timely manner in accordance with the permanency plan, and to complete whatever steps are necessary to finalize the permanent placement of the child; `(D) reasonable efforts of the type described in subparagraph (B) shall not be required to be made with respect to a parent of a child if a court of competent jurisdiction has determined that-- `(i) the parent has subjected the child to aggravated circumstances (as defined in State law, which definition may include but need not be limited to abandonment, torture, chronic abuse, and sexual abuse); `(ii) the parent has-- `(I) committed murder (which would have been an offense under section 1111(a) of title 18, United States Code, if the offense had occurred in the special maritime or territorial jurisdiction of the United States) of another child of the parent; `(II) committed voluntary manslaughter (which would have been an offense under section 1112(a) of title 18, United States Code, if the offense had occurred in the special maritime or territorial jurisdiction of the United States) of another child of the parent; `(III) aided or abetted, attempted, conspired, or solicited to commit such a murder or such a voluntary manslaughter; or `(IV) committed a felony assault that results in serious bodily injury to the child or another child of the parent; or `(iii) the parental rights of the parent to a sibling have been terminated involuntarily; `(E) if reasonable efforts of the type described in subparagraph (B) are not made with respect to a child as a result of a determination made by a court of competent jurisdiction in accordance with subparagraph (D)-- `(i) a permanency hearing (as described in section 475(5)(C)) shall be held for the child within 30 days after the determination; and `(ii) reasonable efforts shall be made to place the child in a timely manner in accordance with the permanency plan, and to complete whatever steps are necessary to finalize the permanent placement of the child; and `(F) reasonable efforts to place a child for adoption or with a legal guardian may be made concurrently with reasonable efforts of the type described in subparagraph (B);'. (b) DEFINITION OF LEGAL GUARDIANSHIP- Section 475 of such Act (42 U.S.C. 675) is amended by adding at the end the following: `(7) The term `legal guardianship' means a judicially created relationship between child and caretaker which is intended to be permanent and self-sustaining as evidenced by the transfer to the caretaker of the following parental rights with respect to the child: protection, education, care and control of the person, custody of the person, and decisionmaking. The term `legal guardian' means the caretaker in such a relationship.'. (c) CONFORMING AMENDMENT- Section 472(a)(1) of such Act (42 U.S.C. 672(a)(1)) is amended by inserting `for a child' before `have been made'. (d) RULE OF CONSTRUCTION- Part E of title IV of such Act (42 U.S.C. 670-679) is amended by inserting after section 477 the following: `SEC. 478. RULE OF CONSTRUCTION. `Nothing in this part shall be construed as precluding State courts from exercising their discretion to protect the health and safety of children in individual cases, including cases other than those described in section 471(a)(15)(D).'. SEC. 102. INCLUDING SAFETY IN CASE PLAN AND CASE REVIEW SYSTEM REQUIREMENTS. Title IV of the Social Security Act (42 U.S.C. 601 et seq.) is amended-- (1) in section 422(b)(10)(B)-- (A) in clause (iii)(I), by inserting `safe and' after `where'; and (B) in clause (iv), by inserting `safely' after `remain'; and (2) in section 475-- (A) in paragraph (1)-- (i) in subparagraph (A), by inserting `safety and' after `discussion of the'; and (ii) in subparagraph (B)-- (I) by inserting `safe and' after `child receives'; and (II) by inserting `safe' after `return of the child to his own'; and (B) in paragraph (5)-- (i) in subparagraph (A), in the matter preceding clause (i), by inserting `a safe setting that is' after `placement in'; and (ii) in subparagraph (B)-- (I) by inserting `the safety of the child,' after `determine'; and (II) by inserting `and safely maintained in' after `returned to'. SEC. 103. STATES REQUIRED TO INITIATE OR JOIN PROCEEDINGS TO TERMINATE PARENTAL RIGHTS FOR CERTAIN CHILDREN IN FOSTER CARE. ( a) REQUIREMENT FOR PROCEEDINGS- Section 475(5) of the Social Security Act (42 U.S.C. 675(5)) is amended-- (1) by striking `and' at the end of subparagraph (C); (2) by striking the period at the end of subparagraph (D) and inserting `; and'; and (3) by adding at the end the following: `(E) in the case of a child who has been in foster care under the responsibility of the State for 15 of the most recent 22 months, or, if a court of competent jurisdiction has determined a child to be an abandoned infant (as defined under State law) or has made a determination that the parent has committed murder of another child of the parent, committed voluntary manslaughter of another child of the parent, aided or abetted, attempted, conspired, or solicited to commit such a murder or such a voluntary manslaughter, or committed a felony assault that has resulted in serious bodily injury to the child or to another child of the parent, the State shall file a petition to terminate the parental rights of the child's parents (or, if such a petition has been filed by another party, seek to be joined as a party to the petition), and, concurrently, to identify, recruit, process, and approve a qualified family for an adoption, unless-- `(i) at the option of the State, the child is being cared for by a relative; `(ii) a State agency has documented in the case plan (which shall be available for court review) a compelling reason for determining that filing such a petition would not be in the best interests of the child; or `(iii) the State has not provided to the family of the child, consistent with the time period in the State case plan, such services as the State deems necessary for the safe return of the child to the child's home, if reasonable efforts of the type described in section 471(a)(15)(B)(ii) are required to be made with respect to the child.'. (b) DETERMINATION OF BEGINNING OF FOSTER CARE- Section 475(5) of the Social Security Act (42 U.S.C. 675(5)), as amended by subsection (a), is amended-- (1) by striking `and' at the end of subparagraph (D); (2) by striking the period at the end of subparagraph (E) and inserting `; and'; and (3) by adding at the end the following: `(F) a child shall be considered to have entered foster care on the earlier of-- `(i) the date of the first judicial finding that the child has been subjected to child abuse or neglect; or `(ii) the date that is 60 days after the date on which the child is removed from the home.'. (c) TRANSITION RULES- (1) NEW FOSTER CHILDREN- In the case of a child who enters foster care (within the meaning of section 475(5)(F) of the Social Security Act) under the responsibility of a State after the date of the enactment of this Act-- (A) if the State comes into compliance with the amendments made by subsection (a) of this section before the child has been in such foster care for 15 of the most recent 22 months, the State shall comply with section 475(5)(E) of the Social Security Act with respect to the child when the child has been in such foster care for 15 of the most recent 22 months; and (B) if the State comes into such compliance after the child has been in such foster care for 15 of the most recent 22 months, the State shall comply with such section 475(5)(E) with respect to the child not later than 3 months after the end of the first regular session of the State legislature that begins after such date of enactment. (2) CURRENT FOSTER CHILDREN- In the case of children in foster care under the responsibility of the State on the date of the enactment of this Act, the State shall-- (A) not later than 6 months after the end of the first regular session of the State legislature that begins after such date of enactment, comply with section 475(5)(E) of the Social Security Act with respect to not less than 1/3 of such children as the State shall select, giving priority to children for whom the permanency plan (within the meaning of part E of title IV of the Social Security Act) is adoption and children who have been in foster care for the greatest length of time; (B) not later than 12 months after the end of such first regular session, comply with such section 475(5)(E) with respect to not less than 2/3 of such children as the State shall select; and (C) not later than 18 months after the end of such first regular session, comply with such section 475(5)(E) with respect to all of such children. (3) TREATMENT OF 2-YEAR LEGISLATIVE SESSIONS- For purposes of this subsection, in the case of a State that has a 2-year legislative session, each year of the session is deemed to be a separate regular session of the State legislature. (4) REQUIREMENTS TREATED AS STATE PLAN REQUIREMENTS- For purposes of part E of title IV of the Social Security Act, the requirements of this subsection shall be treated as State plan requirements imposed by section 471(a) of such Act. (d) RULE OF CONSTRUCTION- Nothing in this section or in part E of title IV of the Social Security Act (42 U.S.C. 670 et seq.), as amended by this Act, shall be construed as precluding State courts or State agencies from initiating the termination of parental rights for reasons other than, or for timelines earlier than, those specified in part E of title IV of such Act, when such actions are determined to be in the best interests of the child, including cases where the child has experienced multiple foster care placements of varying durations. SEC. 104. NOTICE OF REVIEWS AND HEARINGS; OPPORTUNITY TO BE HEARD. Section 475(5) of the Social Security Act (42 U.S.C. 675(5)), as amended by section 103, is amended-- (1) by striking `and' at the end of subparagraph (E); (2) by striking the period at the end of subparagraph (F) and inserting `; and'; and (3) by adding at the end the following: `(G) the foster parents (if any) of a child and any preadoptive parent or relative providing care for the child are provided with notice of, and an opportunity to be heard in, any review or hearing to be held with respect to the child, except that this subparagraph shall not be construed to require that any foster parent, preadoptive parent, or relative providing care for the child be made a party to such a review or hearing solely on the basis of such notice and opportunity to be heard.'. SEC. 105. USE OF THE FEDERAL PARENT LOCATOR SERVICE FOR CHILD WELFARE SERVICES. Section 453 of the Social Security Act (42 U.S.C. 653) is amended-- (1) in subsection (a)(2)-- (A) in the matter preceding subparagraph (A), by inserting `or making or enforcing child custody or visitation orders,' after `obligations,'; and (B) in subparagraph (A)-- (i) by striking `or' at the end of clause (ii); (ii) by striking the comma at the end of clause (iii) and inserting `; or'; and (iii) by inserting after clause (iii) the following: `(iv) who has or may have parental rights with respect to a child,'; and (2) in subsection (c)-- (A) by striking the period at the end of paragraph (3) and inserting `; and'; and (B) by adding at the end the following: `(4) a State agency that is administering a program operated under a State plan under subpart 1 of part B, or a State plan approved under subpart 2 of part B or under part E.'. SEC. 106. CRIMINAL RECORDS CHECKS FOR PROSPECTIVE FOSTER AND ADOPTIVE PARENTS. Section 471(a) of the Social Security Act (42 U.S.C. 671(a)) is amended-- (1) by striking `and' at the end of paragraph (18); (2) by striking the period at the end of paragraph (19) and inserting `; and'; and (3) by adding at the end the following: `(20)(A) unless an election provided for in subparagraph (B) is made with respect to the State, provides procedures for criminal records checks for any prospective foster or adoptive parent before the foster or adoptive parent may be finally approved for placement of a child on whose behalf foster care maintenance payments or adoption assistance payments are to be made under the State plan under this part, including procedures requiring that-- `(i) in any case in which a record check reveals a felony conviction for child abuse or neglect, for spousal abuse, for a crime against children (including child pornography), or for a crime involving violence, including rape, sexual assault, or homicide, but not including other physical assault or battery, if a State finds that a court of competent jurisdiction has determined that the felony was committed at any time, such final approval shall not be granted; and `(ii) in any case in which a record check reveals a felony conviction for physical assault, battery, or a drug-related offense, if a State finds that a court of competent jurisdiction has determined that the felony was committed within the past 5 years, such final approval shall not be granted; and `(B) subparagraph (A) shall not apply to a State plan if the Governor of the State has notified the Secretary in writing that the State has elected to make subparagraph (A) inapplicable to the State, or if the State legislature, by law, has elected to make subparagraph (A) inapplicable to the State.'. SEC. 107. DOCUMENTATION OF EFFORTS FOR ADOPTION OR LOCATION OF A PERMANENT HOME. Section 475(1) of the Social Security Act (42 U.S.C. 675(1)) is amended-- (1) in the last sentence-- (A) by striking `the case plan must also include'; and (B) by redesignating such sentence as subparagraph (D) and indenting appropriately; and (2) by adding at the end the following: `(E) In the case of a child with respect to whom the permanency plan is adoption or placement in another permanent home, documentation of the steps the agency is taking to find an adoptive family or other permanent living arrangement for the child, to place the child with an adoptive family, a fit and willing relative, a legal guardian, or in another planned permanent living arrangement, and to finalize the adoption or legal guardianship. At a minimum, such documentation shall include child specific recruitment efforts such as the use of State, regional, and national adoption exchanges including electronic exchange systems.'. TITLE II--INCENTIVES FOR PROVIDING PERMANENT FAMILIES FOR CHILDREN SEC. 201. ADOPTION INCENTIVE PAYMENTS. (a) IN GENERAL- Part E of title IV of the Social Security Act (42 U.S.C. 670-679) is amended by inserting after section 473 the following: `SEC. 473A. ADOPTION INCENTIVE PAYMENTS. `(a) GRANT AUTHORITY- Subject to the availability of such amounts as may be provided in advance in appropriations Acts for this purpose, the Secretary shall make a grant to each State that is an incentive-eligible State for a fiscal year in an amount equal to the adoption incentive payment payable to the State under this section for the fiscal year, which shall be payable in the immediately succeeding fiscal year. `(b) INCENTIVE-ELIGIBLE STATE- A State is an incentive-eligible State for a fiscal year if-- `(1) the State has a plan approved under this part for the fiscal year; `(2) the number of foster child adoptions in the State during the fiscal year exceeds the base number of foster child adoptions for the State for the fiscal year; `(3) the State is in compliance with subsection (c) for the fiscal year; `(4) in the case of fiscal years 2001 and 2002, the State provides health insurance coverage to any child with special needs (as determined under section 473(c)) for whom there is in effect an adoption assistance agreement between a State and an adoptive parent or parents; and `(5) the fiscal year is any of fiscal years 1998 through 2002. Major Challenges Attorneys and judges involved in child abuse and neglect cases must understand not only the law but also medicine, social work, psychology, child development, and public healthcare finance. Major Points We still don’t truly understand the answers to these (and many other) questions: Is it sometimes better to do nothing? Is removal worth the trauma of removal? What exactly does permanency mean? What does it mean to be ―safe‖? If the State assumes responsibility for a child, how far must it go to ensure that child’s well- being? Major Challenges Our courts and agencies charged with addressing these issues are fragmented, divided, and often inefficient Specific Challenges: Juvenile Justice SB 440 Designated Felony Act Detention of Status Offenders Short Term Program Budget Issues Specific Challenges: Juvenile Justice Remove Aggravated Child Molestation and Aggravated Sodomy from the List of SB 440 Offenses 1994-2006, approximately 100 children in Dekalb County charged as adults with aggravated child molestation. 88% of those children’s cases were either no-billed by the grand jury or prosecuted in juvenile court. BUT in the interim many of them sat without services in the RYDC Specific Challenges: Juvenile Justice Modify the Designated Felony Act Reduce the number of crimes Make the ages uniform Give the Judges more discretion than simply 1-5 years. Look possibly at blended sentencing Secure Commitment Placements YDC Commitment Types 90% Average Length of Stay 80% 700 – 800 days 70% 60% 50% Average Length of Stay 40% 300 - 400 days 30% 20% 10% 0% FY00 FY01 FY02 FY03 FY04 FY05 Commitment Designated Felon Superior Court Commitment OFFICE OF PLANNING 2006 BUDGET November (), AND 44 Community-Based Services Program: Community Non-Secure Program Cost Comparisons (Per Youth-Per Day) Services Secure Facility Confinement $186 Electronic Monitoring (Radio) $6 Electronic Monitoring (Satellite) $16 Intensive Supervision Program $38 Weekend Sanctions $45 Community Services Tracking Services $50 Multi-Systemic Therapy $53 Family Based Intervention Services $55 Wilderness Program $121 $0 $20 $40 $60 $80 $100 $120 $140 $160 $180 $200 Average community placement per day cost = $14 OFFICE OF PLANNING 2006 BUDGET November (), AND 45 Specific Challenges: Juvenile Justice Make the Status Offender Rules Consistent With Federal Law www.childwelfare.net Problem: We don’t have the data from the independent courts, so we can’t tell how we’re doing. Specific Challenges: Deprivation Medicaid Unbundling Child and Family Services Review Major Challenges: Deprivation Medicaid Unbundling Separation of Room, Board, and Watchful Oversight from Behavioral Services A confusing process involving too many agencies with no clear lines of reporting or authority Except for six PRTFs, residential providers have been required to physically separate residential services from behavioral services Many can’t afford the expense, are going out of the business DCH tells DHR that CMS DHR tells residential Is requiring unbundling Provider how to Implement unbundling APS disagrees with DFCS DFCS second- APS Healthcare guesses APS Determines DFCS/DJJ Residential Needed Determine level Provider Therapy Of RBWO Takes child DFCS second-guesses ORS ORS licenses Core Provider determines Residential child needs care provider Specific Challenges: Deprivation Child and Family Services Review Safety Outcomes Are children free of abuse and neglect? Timeliness of investigations, repeat maltreatment Are children maintained safely in their homes where possible? Services to prevent removal, assessing risk of harm to child Specific Challenges: Deprivation Child and Family Services Review Permanency Outcomes Children have permanency and stability in their living situations Timeliness and permanency of reunification, timelineness of adoptions, permanency for children in foster care for extended time periods, placement stability Continuity of family relationships and connections is preserved for children Proximity of placement, visitation with family and siblings Specific Challenges: Deprivation Child and Family Services Review Well-being Outcomes Families have enhanced capacity to provide for their children’s needs Needs of family met, involvement of family in case planning, worker visits with parents and children Children receive appropriate educational services Children receive adequate mental and physical health services Also systemic factors: case reviews, SACWIS, training, etc. Specific Challenges: Deprivation Child and Family Services Review Positives: Low rates of foster care re-entry Low repeat maltreatment Visits between children and families Placing children together Meeting physical health needs of children Specific Challenges: Deprivation Child and Family Services Review Negatives: Met none of the federal standards for the composite outcomes Assessing risk Permanency – timeliness Insufficient efforts to engage fathers Insufficient visitation among siblings placed apart Adequate handling of cases of older youth, especially in terms of appropriate placements Specific Challenges: Deprivation Top Three Issues 1. The permanency choices of Adoption and APPLA (aging out and long term foster care)...making sure that any child over 14 has access to the great services provided by GA-the report says that youth are receiving the services gave them high marks, but we have an access problem. Judges can help with that. -Remember, GA MET the federal standard on reunification and placement with a relative (represents 70% of the children coming thru our child welfare system according to the AFCARs data) which is great news. 2. Meaningful involvement of family members on every level from visitation, to case planning, to relationships, to family team meetings 3. Well-being of children in foster care (although the children in care fared better on these #s than the children in CPS cases). Think about what could be done from the bench to ensure that children get their health and educational needs met. Opportunities Community-based care Guardianship improvements Improving representation Revamping payment systems Obtaining data Promising Practices KidsNet – System of Care http://www.systemsofcare.samhsa.gov SafeCare Dr. John Lutzker, Marcus Institute http://www.marcus.org/clinical/child_well.html Family-Centered Practice Bottom line: Go to the families; don’t make the families come to you.
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